REQUEST FOR QUALIFICATIONS

Medical Control Doctor St. George Fire Department and St, George Consolidated Communications Center City of St. George, UT

BACKGROUND AND PURPOSE

The City of St. George, UT (“City”) is seeking qualified physicians to provide Medical Control services in support of two distinct but operationally interconnected public safety functions: the St. George Fire Department and the St. George Consolidated Communications Center. The Medical Control Doctor serves as the authorizing and supervising physician for emergency medical services (EMS) delivered by fire department personnel and for pre-arrival medical instruction provided by communications center dispatchers.

The St. George Fire Department operates multiple fire stations throughout the City, providing advanced life support (ALS) and basic life support (BLS) emergency medical care to residents, visitors, and others within the City of St. George, UT's jurisdiction. The St. George Consolidated Communications Center serves as the public safety answering point (PSAP) responsible for emergency call processing, dispatching, and the delivery of pre-arrival medical instructions to callers awaiting the arrival of emergency personnel and serves all of Washington County Utah.

Medical oversight is a legally required and operationally essential component of both systems. The Medical Control Doctor acts as the licensed physician of record, ensuring that all medical protocols, procedures, training, and quality assurance activities meet the applicable standards established under Utah law and accepted national EMS standards of care. The City expects the selected physician to function as a fully integrated clinical partner, embedded in the operational culture of both agencies, and committed to the continuous advancement of prehospital and dispatch-level medical care throughout the community. In addition, the medical control doctor will be expected to assist with department training, evaluate incidents, attend coordination, compliance and control meetings.

SCOPE OF SERVICES

The selected physician will be expected to provide a comprehensive range of medical direction and oversight services across both the St. George Fire Department and the St. George Consolidated Communications Center. The scope is organized below into five functional areas, each of which represents a core pillar of the Medical Control Doctor's responsibilities under this engagement.

1. Medical Protocol Development and Maintenance The Medical Control Doctor shall be responsible for establishing, reviewing, and maintaining all standing orders and treatment protocols used by EMS personnel operating under the St. George Fire Department, as well as all pre-arrival instruction protocols and ancillary post-dispatch instructions (PDI), key questions, emergency medical calls used by emergency medical dispatchers at the St. George Consolidated Communications Center. This functional area encompasses the full lifecycle of protocol governance, from initial development through periodic review, revision, and formal approval.

For the St. George Fire Department, the physician shall:

- Develop and maintain written standing orders that authorize EMS personnel to perform specific medical interventions in the field without requiring direct real-time physician contact, ensuring that all standing orders reflect current evidence-based practices and are consistent with the scope of practice authorized under Utah law for each licensure level represented in the department

- Review all ALS and BLS treatment protocols on a minimum annual basis, or more frequently as required by changes in medical evidence, state regulatory standards, or operational findings from quality assurance activities

- Develop and revise protocols in alignment with the requirements of the Utah Bureau of Emergency Medical Services and Preparedness and in accordance with the standards of nationally recognized EMS clinical authorities

- Ensure that protocols address the full spectrum of medical emergencies encountered in the field, including but not limited to cardiac arrest, respiratory distress, stroke and neurological emergencies, traumatic injury, pediatric emergencies, toxicological events, obstetric emergencies, hypoglycemia, anaphylaxis, and behavioral health crises

- Coordinate with receiving hospitals and regional healthcare facilities as needed to align local protocols with hospital capabilities, diversion practices, and destination policies relevant to the service area.

- Document all protocol changes with version control notation, effective dates, and a record of physician authorization to support audit readiness and regulatory compliance For the St. George Consolidated Communications Center, the physician shall:

- Review and formally authorize pre-arrival medical instruction scripts and protocols used by emergency medical dispatchers, ensuring clinical accuracy and alignment with current standards for conditions including cardiac arrest, choking, childbirth, hemorrhage control, and other time-sensitive emergencies

- Approve all clinically driven modifications to dispatcher protocols prior to implementation, and maintain documentation of each approval action

- Provide written guidance to communications center supervisors when updates to dispatcher protocols are indicated based on quality assurance findings, changes in clinical best practices, or regulatory direction

- Ensure that pre-arrival instruction content is consistent with the clinical expectations established in field-level protocols so that dispatcher guidance and EMS field response represent a coordinated continuum of care

2. Training and Education The Medical Control Doctor shall serve as the primary physician-level educational resource for EMS personnel at the St.. George Fire Department and for emergency medical dispatchers at the St. George Consolidated Communications Center. Training and education responsibilities span initial orientation through ongoing professional development and shall be delivered in formats appropriate to the operational environment and learning needs of each audience.

Responsibilities under this functional area include:

-The Medical Director will meet with Command Staff annually to review and approve all treatment protocols and standing orders for the following calendar year, and shall vet and authorize the adoption of any new medications, equipment, or advanced scopes of practice during this cycle.

- Developing or formally approving continuing medical education curricula for field-level EMS personnel at all licensure levels represented within the St. George Fire Department, ensuring that educational content is current, clinically relevant, and aligned with protocol expectations.

- Planning and conducting or facilitating in-person training sessions (no fewer than two training sessions per calendar year), skills evaluations, and case-based learning exercises on a scheduled basis and in response to emerging training needs identified through quality assurance review.

-Clinical focus areas will be selected by EMS Specialists and Command Staff based on operational data and field trends, Training will focus on Pathophysiology and advanced diagnostic reasoning. Examples of focus areas include, but are not limited to: Chest Pain, Syncopal Episodes, Frequent Falls, and Generalized Sickness/Sepsis.

- Providing didactic instruction, or directly supervising instruction delivered by designees, when new protocols, pharmacological agents, medical equipment, or clinical procedures are introduced to the EMS system.

- Participating in new hire orientation processes to ensure that incoming EMS personnel receive a thorough introduction to the medical direction framework, current standing orders, documentation expectations, and the role of the Medical Control Doctor within the St. George Fire Department's operational structure.

- Supporting the clinical components of emergency medical dispatcher training at the St. George Consolidated Communications Center, including review of dispatcher education materials for medical accuracy and participation in case review sessions that address clinically complex or high-acuity call scenarios.

- Maintaining availability to serve as a clinical consultant for supervisory and training personnel at both the fire department and the communications center when questions arise outside of scheduled training activities.

- Ensuring that all training activities delivered or approved under this engagement are documented in a manner that supports personnel certification records and agency compliance reporting.

- Review and approve the Comprehensive Training Plan for the upcoming year to ensure medical accuracy.

-Formally authorizes SGFD EMS Training Officers to conduct and sign off on annual psychomotor skills verifications for all licensed personnel.

-Approve the evaluation methodology and checklists used by Training Officers to ensure they meet NREMT and State standards.

3. Quality Assurance and Quality Improvement A core function of the Medical Control Doctor is the sustained, systematic review of patient care delivery and call-handling performance to ensure that all services provided under the authority of the City meet the highest attainable standards of care. Quality assurance under this engagement is not limited to the identification of deficiencies but encompasses recognition of exemplary performance, trend analysis, system-level improvement planning, and accountability follow-through. These duties include:

- Conduct regular review of a statistically representative sample of patient care reports generated by St. George Fire Department EMS personnel, applying consistent clinical criteria to assess documentation quality, protocol adherence, medication administration accuracy, and overall patient care decision-making.

- Identify trends across the reviewed data set that indicate systemic strengths, recurring deficiencies, training needs, or protocol gaps, and communicate findings to EMS supervisory personnel through structured written feedback.

- Perform case-specific review for any call involving a patient death in the field or within a clinically significant timeframe following EMS contact, a formal complaint regarding the actions of EMS personnel, a documented deviation from standing orders, an adverse medication event, or any other outcome identified by department leadership as warranting physician-level review.

- Review a representative sample of emergency medical dispatch recordings from the St. George Consolidated Communications Center to evaluate dispatcher adherence to approved pre-arrival instruction protocols, the accuracy of clinical guidance provided to callers, and the timeliness and quality of emergency response coordination.

- Participate in and, where appropriate, lead multidisciplinary case review meetings that bring together personnel from the St. George Fire Department and the St. George Consolidated Communications Center to examine system-level performance and identify opportunities for coordinated improvement.

- Prepare and deliver periodic written quality assurance reports to the CityUT leadership that summarize findings from both patient care report reviews and dispatch recording reviews, identify trends over time, and provide prioritized recommendations for system improvement.

- Recommend specific corrective actions in response to identified deficiencies and maintain a tracking mechanism to document whether corrective actions have been implemented and whether the targeted improvement has been achieved within agreed-upon timeframes.

- Contribute to after-action review processes following mass casualty incidents, declared emergencies, or other large-scale events in which the medical and dispatch performance of City personnel warrants structured evaluation.

4. Physician Availability and Regulatory Compliance The Medical Control Doctor shall maintain a defined and reliable level of availability to support EMS field personnel and emergency medical dispatchers in both routine and urgent situations, while simultaneously fulfilling all obligations required to maintain the City's compliance with applicable state and federal regulatory requirements. These two responsibilities are presented together because both are non-negotiable elements of lawful EMS system operation and because lapses in either area carry direct consequences for the ability of the City to continue providing authorized EMS services.

With respect to physician availability and consultation, the physician shall:

- Establish and maintain a reliable mechanism through which EMS personnel in the field may reach a physician for online medical direction when a patient care situation falls outside the scope of standing orders, requires direct physician authorization, or involves a level of clinical complexity that warrants real-time physician input.

- Define clear on-call and coverage protocols that ensure physician access at all hours of the day, including nights, weekends, and holidays, so that the absence of online medical direction is never a barrier to appropriate patient care.

- Coordinate with the City in advance of any period during which the primary Medical Control Doctor will be unavailable, and confirm that an appropriately credentialed and briefed coverage physician has been designated and is accessible.

- Establish a defined response timeframe for requests from St. George Fire Department command staff or St. George Consolidated Communications Center leadership regarding acute clinical or operational matters, with the specific timeframe to be incorporated into the executed agreement.

- Maintain availability for non-emergency consultation with supervisory, training, and administrative personnel at both agencies, with responsiveness expectations to be defined in the agreement.

With respect to regulatory compliance and licensure oversight, the physician shall:

- Serve as the authorizing and sponsoring physician for EMS personnel certification as required by the statutes and administrative rules of the Utah Bureau of Emergency Medical Services and Preparedness, and fulfill all documentation and reporting obligations associated with that role.

- Maintain an unrestricted license to practice medicine in the State of Utah and all specialty certifications required under state EMS regulations in continuous good standing throughout the term of the agreement, and promptly notify City leadership of any change in licensure status.

- Assist with the preparation, review, and submission of documentation required for agency licensure renewals, state inspections, and audits, and respond in a timely manner to information requests from state regulators related to the EMS activities conducted under the physician's medical direction.

- Advise fire department and communications center leadership on a proactive basis regarding changes to state or federal regulations, including updates to Utah Bureau of Emergency Medical Services and Preparedness administrative rules and National Highway Traffic Safety Administration EMS guidelines, that may affect protocols, certification requirements, or dispatch standards.

- Incorporate applicable provisions of nationally accepted EMS standards, including those issued by recognized national EMS medical authorities, into local protocols and training content as appropriate for the St. George operating environment.

5. Coordination, Administration, and Deliverables The Medical Control Doctor shall maintain an active, collaborative, and administratively engaged working relationship with leadership at both the St. George Fire Department and the St. George Consolidated Communications Center. This functional area encompasses the recurring administrative responsibilities of the engagement as well as the formal deliverables the physician is expected to produce and maintain throughout the term of the agreement.

Administrative and coordination responsibilities include:

- Attending regularly scheduled meetings with EMS and communications center leadership at a frequency mutually agreed upon by all parties, and contributing substantively to agenda items related to medical direction, protocol status, quality assurance findings, and training needs.

-Quarterly sit-ins at the PSAP (1-2 hours).

- Participating in after-action reviews following mass casualty incidents, declared disasters, or other large-scale emergency events in which City EMS and dispatch resources were significantly engaged, and providing physician-level perspective on clinical performance and system response.

- Contributing to the development and periodic review of operational policies related to EMS functions, including policies governing controlled substance and medication storage, administration, and reconciliation; medical equipment inspection and maintenance; and patient care data reporting and records management.

- Providing written reports, declarations, or testimony as required in legal, administrative, or regulatory proceedings involving patient care delivered or dispatch guidance provided under the physician's medical direction.

- Coordinating with City risk management and legal personnel as needed in connection with EMS-related matters, including incident investigations, insurance matters, and liability inquiries.

- Maintaining organized records of all activities performed under this engagement in a format accessible to City administrators for audit, reporting, and continuity purposes.

Throughout the term of the agreement, the Medical Control Doctor shall assist with the following deliverables on a schedule to be formally agreed upon with the City:

- Approves and assist in developing standing orders and ALS and BLS treatment protocols for the St. George Fire Department, updated at minimum annually and whenever substantive clinical or regulatory changes require revision, with version control documentation for each update.

- Formally approve pre-arrival medical instruction protocols for the St. George Consolidated Communications Center, with documented approval records for each version in effect.

- Periodic quality assurance reports summarizing findings from patient care report reviews and dispatch recording reviews, including trend analyses and prioritized improvement recommendations.

- Written corrective action recommendations issued in response to identified deficiencies, accompanied by follow-up documentation confirming implementation status and outcome.

- Documentation of all training sessions conducted or formally approved under this engagement, including content, date, attendees, and competency outcomes where applicable.

- Regulatory compliance correspondence, licensure support documentation, and sponsorship records as required by the Utah Bureau of Emergency Medical Services and Preparedness.

- Availability and coverage schedules confirming physician access arrangements for online medical direction services, updated as needed to reflect changes in coverage arrangements.

MINIMUM QUALIFICATIONS

Candidates must demonstrate all of the following to be considered for this engagement:

- A current, unrestricted license to practice medicine in the State of Utah, maintained in good standing throughout the term of any agreement entered into with the City.

- Board certification in emergency medicine or a closely related specialty, or a documented record of equivalent clinical experience in emergency and prehospital medicine sufficient to demonstrate competency in the full scope of responsibilities described in this solicitation.

- Demonstrated familiarity with Utah EMS licensure statutes, the administrative rules of the Utah Bureau of Emergency Medical Services and Preparedness, and the procedural requirements associated with serving as a sponsoring physician under Utah law.

- Knowledge of emergency medical dispatch systems and familiarity with structured dispatcher protocol programs used in PSAP environments.

- Demonstrated ability to develop, implement, evaluate, and revise EMS treatment protocols across both ALS and BLS levels of care.

- Experience conducting systematic quality assurance reviews of patient care reports and, where applicable, dispatch recordings or communications center performance data.

- Strong interpersonal and written communication skills sufficient to engage effectively with fire department personnel at all ranks, emergency medical dispatch staff, City administrative and legal leadership, state regulators, and the public.

-Certification or be willing to be certified in the Emergency Medical Dispatch system the PSAP utilizes (ProQA/Priority Dispatch).

-Disclose any malpractice claims or lawsuits involving or connected to the physician’s medical practice at any time, and provide status of same. Documentation may be required.

TERM AND ENGAGEMENT STRUCTURE

The City anticipates entering into an initial agreement for a period to be specified in the final contract documents, with options for renewal contingent upon satisfactory performance and the ongoing operational needs of the St. George Fire Department and the St. George Consolidated Communications Center. The selected physician may be engaged as an independent contractor or through a practice group arrangement, subject to the contracting requirements, insurance standards, and procurement policies of the City. All services shall be performed in compliance with applicable provisions of Utah law and any requirements established by the City's risk management program.